POPULARITY
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Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels. Additional noncompetitive beta-blocker effects. Stabilizes cardiac tissue, slows heart rate, and suppresses both atrial and ventricular arrhythmias. Lidocaine Blocks fast sodium channels in ventricular tissue (Class Ib). Shortens the action potential in ventricular myocardium, especially in ischemic tissue. Suppresses abnormal automaticity in damaged/irritable myocardium. Which one should you pick for a patient in vtach/vfib cardiac arrest? The current guidelines recommend amiodarone for shock-refractory cases but this is based on randomized trials showing better arrhythmia termination and short-term outcomes, but not long-term survival benefits. Two recent studies suggest that lidocaine might actually be preferable. A 2023 paper published in Chest Performed a large retrospective cohort study for treating in-hospital VT/VF cardiac arrest. Among more than 14,000 patients, lidocaine was associated with higher rates of ROSC, 24-hour survival, survival to discharge, and favorable neurologic outcomes. These results held after adjusting for covariates and using propensity score methods. Overall, lidocaine outperformed amiodarone across all major clinical outcomes in this population. A 2025 paper published in Resuscitation Performed a target trial emulation in adults with out-of-hospital shockable cardiac arrest. After propensity score matching in more than 23,000 eligible cases, lidocaine was associated with higher odds of prehospital ROSC, fewer post-drug defibrillations, and greater survival to hospital discharge. These advantages were consistent across matched patient pairs. Dose for lidocaine is an initial 1-1.5 mg/kg IV bolus, followed by additional boluses of 0.5-0.75 mg/kg every 5-10 minutes up to a total of 3 mg/kg if needed. Dose for amiodarone is a 300 mg bolus followed by an additional 150 mg bolus if needed. References Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018 Oct;15(10):e190-e252. doi: 10.1016/j.hrthm.2017.10.035. Epub 2017 Oct 30. Erratum in: Heart Rhythm. 2018 Nov;15(11):e278-e281. doi: 10.1016/j.hrthm.2018.09.026. PMID: 29097320. Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J. A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025 Mar;208:110515. doi: 10.1016/j.resuscitation.2025.110515. Epub 2025 Jan 23. PMID: 39863130; PMCID: PMC11908894. Wagner D, Kronick SL, Nawer H, Cranford JA, Bradley SM, Neumar RW. Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest. Chest. 2023 May;163(5):1109-1119. doi: 10.1016/j.chest.2022.10.024. Epub 2022 Nov 2. PMID: 36332663. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/
In this episode, the CardioNerds (Dr. Naima Maqsood, Dr. Akiva Rosenzveig, and Dr. Colin Blumenthal) are joined by renowned educator in electrophysiology, Dr. Joshua Cooper, to discuss everything atrial flutter; from anatomy and pathophysiology to diagnosis and management. Dr. Cooper's expert teaching comes through as Dr. Cooper vividly describes atrial anatomy to provide the foundational understanding to be able to understand why management of atrial flutter is unique from atrial fibrillation despite their every intertwined relationship. A foundational episode for learners to understand atrial flutter as well as numerous concepts in electrophysiology. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls "The biggest mistake is failure to diagnose”. Atrial flutter, especially with 2:1 conduction, is commonly missed in both inpatient and outpatient settings so look carefully at that 12-lead EKG so you can mitigate the stroke and tachycardia induced cardiomyopathy risk Decremental conduction of the AV node makes it more challenging to rate control atrial flutter than atrial fibrillation Catheter Ablation is the first line treatment for atrial flutter and is highly successful, but cardioversion can be utilized as well prior to pursuing ablation in some cases. Class I AADs like propafenone and flecainide may stability the atrial flutter circuit by slowing conduction and thus may worsen the arrhythmia. Therefore, the preferred anti-arrhythmic medication in atrial flutter are class III agents. Atrial flutter can be triggered by firing from the left side of the heart, so in patients with both atrial fibrillation and flutter, ablating atrial fibrillation makes atrial flutter less likely to recur. BONUS PEARL: Dr. Cooper's youtube video on atrial flutter is a MUST SEE! Notes Notes: Notes drafted by Dr. Akiva Rosenzveig What are the distinguishing features of atrial fibrillation and flutter? Atrial flutter is an organized rhythm characterized by a wavefront that continuously travels around the same circuit leading to reproducible P-waves on surface EKG as well as a very mathematical and predictable relationship between atrial and ventricular activity Atrial fibrillation is an ever changing, chaotic rhythm that consists of small local circuits that interplay off each other. Consequently, no two beats are the same and the relationship between the atrial activity and ventricular activity is unpredictable leading to an irregularly irregular rhythm What are common atrial flutter circuits? Cavo-tricuspid isthmus (CTI)-dependent atrial flutter is the most common type of flutter. It is characterized by a circuit that circumnavigates the tricuspid valve. Typical atrial flutter is characterized by the circuit running in a counterclockwise pattern up the septum, from medial to lateral across the right atrial roof, down the lateral wall, and back towards the septum across the floor of the right atrium between the IVC and the inferior margin of the tricuspid valve i.e. the cavo-tricuspid isthmus. Surface EKG will show a gradual downslope in leads II, III, and AvF and a rapid rise at end of each flutter wave. Atypical CTI-dependent flutter follows the same route but in the opposite direction (clockwise). Therefore, we will see positive flutter waves in the inferior leads Mitral annular flutter is more commonly seen in atrial fibrillation patients who've been treated with ablation leading to scarring in the left atrium. Roof-dependent flutter is characterized by a circuit that travels around left atrium circumnavigating a lesion (often from prior ablation), traveling through the left atrial roof, down the posterior wall, and around the pulmonary veins Surgical/scar/incisional flutter is seen in people with a history of prior cardiac surgery and have iatrogenic scars in right atrium due to cannulation sites or incisions How does atrial flutter pharmacologic management differ from other atrial arrhythmias? The atrioventricular (AV) node is unique in that the faster it is stimulated, the longer the refractory period and the slower it conducts. This characteristic is called decremental conduction. In atrial fibrillation, the atrial rate is so fast that the AV node becomes overwhelmed and only lets some of those signals through to the ventricles creating an irregular tachycardia but at lower rates. In atrial flutter, the atrial rate is slower, therefore the AV node has more capability to conduct allowing for higher ventricular rates. Therefore, to achieve rate control one will need a higher dose of AV blocking medications. Atrial tachycardia may require even higher doses due to the increased ability of the AV node to conduct, as the atrial rates are slower than in atrial flutter. Sodium channel blockers (Class I) such as flecainide and propafenone slow wavefront propagation, making it easier for the AV node to handle the atrial rates. This will end up leading to increased ventricular rates which can be dangerously fast. That is why AV nodal blockers should be used in conjunction with flecainide and propafenone. What is the role of cardioversion in atrial flutter management? Due to high success rate with atrial flutter ablation, ablation is the first line treatment. However, sometimes cardioversion may be utilized in patients depending on how symptomatic they are and how long it will take to get an ablation. Cardioversion may also be utilized preferentially when the atrial flutter was triggered by infection or cardiac surgery to see if it will come back. If cardioversion is pursued, the patient will need to be anticoagulated due to the stroke risk after the procedure due to post-conversion stunning. How effective is atrial flutter ablation? The landmark Natale et al study in 2000 demonstrated 80% success rate after radiofrequency ablation as compared to 36% in patients on anti-arrhythmic therapy. The LADIP study in 2006 further corroborated these findings. Contemporary data shows above 90% success rate of atrial flutter ablation. In patients who have had both atrial fibrillation and atrial flutter, most electrophysiologists would ablate both. However, in patients with atrial fibrillation, the atrial flutter usually is initiated by trigger spots firing in the left atrium. Once the atrial fibrillation is ablated, the flutter will become less likely. Therefore, there are those who say there's no need to ablate the flutter circuit as well. Alternatively, if a patient has severe comorbidities and/or is high risk for ablation, one may consider performing the atrial flutter ablation only since atrial flutter is harder to manage medically compared with atrial fibrillation. How do you manage atrial flutter in the acute inpatient setting? In the inpatient setting, electrical cardioversion is often limited by blood pressure and the hypotensive effects of the sedatives required. If one is awake and too hypotensive, chemical cardioversion can be pursued. The most effective anti-arrhythmic for this is ibutilide. Amiodarone is not effective for acute cardioversion. Since ibutilide prolongs refractoriness in atrial and ventricular tissue, there's a risk of long QT induced torsades de pointes. Pretreating with magneisum reduces the risk to 1-2%. References Jolly WA, Ritchie WT. Auricular flutter and fibrillation. 1911. Ann Noninvasive Electrocardiol. 2003;8(1):92-96. doi:10.1046/j.1542-474x.2003.08114.x McMichael J. History of atrial fibrillation 1628-1819 Harvey - de Senac - Laënnec. Br Heart J. 1982;48(3):193-197. doi:10.1136/hrt.48.3.193 Lee KW, Yang Y, Scheinman MM; University of Califoirnia-San Francisco, San Francisco, CA, USA. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Probl Cardiol. 2005;30(3):121-167. doi:10.1016/j.cpcardiol.200 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e167. doi:10.1161/ Cosío F. G. (2017). Atrial Flutter, Typical and Atypical: A Review. Arrhythmia & electrophysiology review, 6(2), 55–62. https://doi.org/10.15420/aer.2017.5.2 https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-11/Atrial-flutter-common-and-main-atypical-forms Natale A, Newby KH, Pisanó E, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol. 2000;35(7):1898-1904. doi:10.1016/s0735-1097(00)00635-5 Da Costa A, Thévenin J, Roche F, et al. Results from the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter. Circulation. 2006;114(16):1676-1681. doi:10.1161/CIRCULATIONAHA.106.638395 https://www.acc.org/Membership/Sections-and-Councils/Fellows-in-Training-Section/Section-Updates/2015/12/15/16/58/Atrial-Fibrillation#:~:text=The%20first%20'modern%20day'%20account,in%20open%20chest%20animal%20models.&text=In%201775%2C%20William%20Withering%20first,(purple%20foxglove)%20in%20AFib.
We explore the challenges of Peripheral Arterial Disease (PAD) in women, with two renowned experts: Professor Maarit Venermo and Professor Mirjami Laivuori.Together, we discuss why PAD continues to be underdiagnosed in women despite equal or even higher prevalence, the limitations of the ankle–brachial index (ABI) in female patients, the intricate interplay between estrogen, menopause, and vascular health, the growing trend toward endovascular-first strategies in women, and the conflicting evidence surrounding revascularisation outcomes.An evidence-based and clinically relevant conversation awaits.ReferencesDivakaran S, Krawisz AK, Secemsky EA, Kant S. Sex and Racial Disparities in Peripheral Artery Disease. 2023Jelani QU, Petrov M, Martinez SC, Holmvang L, Al-Shaibi K, Alasnag M. Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile, Clinical Features, and Outcomes. 2018Kozak M, Poredoš P, Blinc A, Kaja Ježovnik M, Poredoš P. Peripheral arterial disease in women. 2024Porras CP, Bots ML, Teraa M, van Doorn S, Vernooij RWM. Differences in Symptom Presentation in Women and Men with Confirmed Lower Limb Peripheral Artery Disease: A Systematic Review and Meta-Analysis. 2022Kavurma MM, Boccanfuso L, Cutmore C, Passam F, Patel S, Hennessy A, Loa J, Figtree GA, Golledge J, Robinson DA, Aitken S. A hidden problem: peripheral artery disease in women. 2023Srivaratharajah K, Abramson BL. Women and Peripheral Arterial Disease: A Review of Sex Differences in Epidemiology, Clinical Manifestations, and Outcomes. 2018Pabon M, Cheng S, Altin SE, Sethi SS, Nelson MD, Moreau KL, Hamburg N, Hess CN. Sex Differences in Peripheral Artery Disease. 2022Twine CP, Kakkos SK, Aboyans V, Baumgartner I, Behrendt CA, Bellmunt-Montoya S, Jilma B, Nordanstig J, Saratzis A, Reekers JA, Zlatanovic P; ESVS Guidelines Committee; Antoniou GA, de Borst GJ, Bastos Gonçalves F, Chakfé N, Coscas R, Dias NV, Hinchliffe RJ, Kolh P, Lindholt JS, Mees BME, Resch TA, Trimarchi S, Tulamo R, Vermassen FEG, Wanhainen A; Document Reviewers; Koncar I, Fitridge R, Matsagkas M, Valgimigli M. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases. 2023Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. 2024
CardioNerds (Dr. Kelly Arps, Dr. Naima Maqsood, and Dr. Elizabeth Davis) discuss chronic AF management with Dr. Edmond Cronin. This episode seeks to explore the chronic management of atrial fibrillation (AF) as described by the 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. The discussion covers the different AF classifications, symptomatology, and management including medications and invasive therapies. Importantly, the episode explores current gaps in knowledge and where there is indecision regarding proper treatment course, as in those with heart failure and AF. Our expert, Dr. Cronin, helps elucidate these gaps and apply guideline knowledge to patient scenarios. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Review the guidelines- Catheter ablation is a Class I recommendation for select patient groups Appropriately recognize AF stages- preAF conditions, symptomatology, classification system (paroxysmal, persistent, long-standing persistent, permanent) Be familiar with the EAST-AFNET4 trial, as it changed the approach of rate vs rhythm control Understand treatment approaches- lifestyle modifications, management of comorbidities, rate vs rhythm control medications, cardioversion, ablation, pulmonary vein isolation, surgical MAZE Sympathize with patients- understand their treatment goals Notes Notes: Notes drafted by Dr. Davis. What are the stages of atrial fibrillation? The stages of AF were redefined in the 2023 guidelines to better recognize AF as a progressive disease that requires different strategies at the different therapies Stage 1 At Risk for AF: presence of modifiable (obesity, lack of fitness, HTN, sleep apnea, alcohol, diabetes) and nonmodifiable (genetics, male sex, age) risk factors associated with AF Stage 2 Pre-AF: presence of structural (atrial enlargement) or electrical (frequent atrial ectopy, short bursts of atrial tachycardia, atrial flutter) findings further pre-disposing a patient to AF Stage 3 AF: patient may transition between these stages Paroxysmal AF (3A): intermittent and terminates within ≤ 7 days of onset Persistent AF (3B): continuous and sustained for > 7 days and requires intervention Long-standing persistent AF (3C): continuous for > 12 months Successful AF ablation (3D): freedom from AF after percutaneous or surgical intervention Stage 4 Permanent AF: no further attempts at rhythm control after discussion between patient and clinician The term chronic AF is considered obsolete and such terminology should be abandoned What are common symptoms of AF? Symptoms vary with ventricular rate, functional status, duration, and patient perception May present as an embolic complication or heart failure exacerbation Most commonly patients report palpitations, chest pain, dyspnea, fatigue, or lightheadedness. Vague exertional intolerance is common Some patients also have polyuria due to increased production of atrial natriuretic peptide Less commonly can present as tachycardia-associated cardiomyopathy or syncope Cardioversion into sinus rhythm may be diagnostic to help determine if a given set of symptoms are from atrial fibrillation to help guide the expected utility of more aggressive rhythm control strategies. What are the current guidelines regarding rhythm control and available options? COR-LOE 1B: In patients with reduced LV function and persistent (or high burden) AF, a trial of rhythm control should be recommended to evaluate whether AF is contributing to the reduced LV function COR-LOE 2a-B: In patients with reduced LV function and persistent (or high burden) AF, a trial of rhythm control should be recommended to evaluate whether AF is contributing to the reduced LV function. In patients with a recent diagnosis of AF (
Dr. Julie Ann Justo is joined by experts Drs. Krista Gens and Javier A. Villafuerte Gálvez as they dive deep into the gut microbiome and explore the latest therapeutic frontier for C. difficile infections. From bacteria battles to breakthrough treatments, this one's a must-listen! You can also review the helpful infographic on our website (https://breakpoints-sidp.org/infographics/). This podcast was supported by an unrestricted grant from Nestlé Health Science. References: Helpful review from one of our guest experts: Gens KD, et al. Fecal microbiota transplantation and emerging treatments for Clostridium difficile infection. J Pharm Pract. 2013 Oct;26(5):498-505. doi: 10.1177/0897190013499527. PMID: 23966282. More modern review: Herbin SR, et al. Breaking the Cycle of Recurrent Clostridioides difficile Infections: A Narrative Review Exploring Current and Novel Therapeutic Strategies. J Pharm Pract. 2024 Dec;37(6):1361-1373. doi: 10.1177/08971900241248883. Epub 2024 May 13. PMID: 38739837. Review on designing microbiota based therapies (pre-print only): Ke S, et al. Rational Design of Live Biotherapeutic Products for the Prevention of Clostridioides difficile Infection. 2024 May 02. doi: 10.1101/2024.04.30.591969. [FDA Guidance regarding IND requirements for fecal microbiota transplant](https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-policy-regarding-investigational-new-drug-requirements-use-fecal-microbiota). 2022 Nov. OpenBiome webpage with resources for hospitals: How to Start an FMT Program. 2025. Peery AF, et al. AGA Clinical Practice Guideline on Fecal Microbiota-Based Therapies for Select Gastrointestinal Diseases. Gastroenterology. 2024 Mar;166(3):409-434. doi: 10.1053/j.gastro.2024.01.008. PMID: 38395525. Johnson S, et al. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clin Infect Dis. 2021 Sep 7;73(5):755-757. doi: 10.1093/cid/ciab718. PMID: 34492699. Henry Ford's experience getting fecal microbiota products for patients: Abene S. Fecal Microbiota Capsules Improve CDI Access Through Specialty Pharmacy Integration. Contagion Live. 2025 Jul 11. An international view on CDI management: Mendo-Lopez R, et al. Best Practices in the Management of Clostridioides difficile Infection in Developing Nations. Trop Med Infect Dis. 2024 Aug 19;9(8):185. doi: 10.3390/tropicalmed9080185. PMID: 39195623. Review on investigational LBP agents: Monday L, et al. Microbiota-Based Live Biotherapeutic Products for Clostridioides Difficile Infection- The Devil is in the Details. Infect Drug Resist. 2024 Feb 15;17:623-639. doi: 10.2147/IDR.S419243. PMID: 38375101. More on quorum sensing: Falà AK, et al. Quorum sensing in human gut and food microbiomes: Significance and potential for therapeutic targeting. Front Microbiol. 2022 Nov 25;13:1002185. doi: 10.3389/fmicb.2022.1002185. PMID: 36504831. Economic impacts of CDI pts: Reilly J, et al. Economic impact of multiple recurrent Clostridioides difficile infection in a community teaching hospital. Infect Control Hosp Epidemiol. 2025 Sep 29:1-3. doi: 10.1017/ice.2025.10295. Epub ahead of print. PMID: 41020576.
Dr. John Fleetham chats with Dr. Barbara Jones about her ATS guideline, "Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline."
This episode reviews definitions and guidance on labor management changes from Clinical Practice Guideline 8. (Originally released February 2024) Twitter: @creogsovercoff1 Instagram: @creogsovercoffee Facebook: www.facebook.com/creogsovercoffee Website: www.creogsovercoffee.com Patreon: www.patreon.com/creogsovercoffee Visit www.acog.org to learn more about the CREOG National Residency Curriculum coming Fall 2025.
In this episode of Disruption/Interruption, host KJ interviews Dr. Jay Greenstein, CEO of Embodi Health, about disrupting the status quo in healthcare. Dr. Greenstein shares his journey from chiropractor to tech entrepreneur, discusses the challenges of patient adherence, and reveals how his company is using AI, behavioral science, and gamification to transform musculoskeletal care and improve patient outcomes. Key Takeaways: The Healthcare System is Broken [4:12]Dr. Greenstein explains how the U.S. healthcare system is plagued by barriers and value extractors, making it difficult for patients to access the right care. Evidence-Based, Non-Pharmacologic Care is Essential [7:14]He emphasizes the importance of following clinical practice guidelines that prioritize non-pharmacologic interventions like spinal manipulation and exercise. Gamification Improves Patient Adherence [16:27]Dr. Greenstein describes how his team built a gamified app to reward patients for adhering to care plans, leading to measurable improvements in outcomes. AI and Remote Monitoring Drive Better Outcomes [18:17]The Embody platform uses AI-driven, evidence-based home exercise programs and remote therapeutic monitoring to keep patients and providers connected and engaged. Quote of the Show (4:12):"I want justice for humanity. I want justice for patients. I want justice for the healthcare system. Our system in the US is broken, and it can be fixed." – Dr. Jay Greenstein Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Dr. Jay Greenstein: LinkedIn: https://www.linkedin.com/in/drjaygreenstein/ Company Website: https://embodihealth.com How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlDSee omnystudio.com/listener for privacy information.
Dr. Sandra Hassink is joined by Dr. Sarah Hampl, Professor of Pediatrics at Children's Mercy in Kansas City, Center for Children's Healthy Lifestyles and Nutrition, and lead author on the 2023 Clinical Practice Guideline on Obesity. Dr. Hassink is also joined by Dr. Sarah Barlow, Professor of Pediatrics at UT Southwestern Medical Center in Dallas, Texas, and executive council member on the section on obesity (SOOb). Together they discuss the 2025 AAP National Conference and Exhibition (NCE). Related Resources: • AAP National Conference and Exhibition, Website (aapexperience.org/) • AAP Section on Obesity (tinyurl.com/3rx2rm4r) • Institute for Healthy Childhood Weight, Website (tinyurl.com/yc88y53j)
Join endocrine expert Dr. David Lieb as he moderates a discussion with Dr. Shailendra Patel, Chair of the 2025 AACE Dyslipidemia Algorithm; Dr. Maria Belalcazar, Vice Chair; and Dr. Robert Hegele, Author and Representative of the Canadian Cardiovascular Society, about the 2025 Updated Algorithm for Management of Adults with Dyslipidemia.This episode covers:The rationale behind updating the algorithm and how it aligns with the 2025 Clinical Practice Guideline for the Pharmacologic Management of Adults with DyslipidemiaKey updates from the 2020 algorithm, including expanded guidance on hypertriglyceridemia and lipid management in special populationsPractical strategies for integrating the algorithm into everyday clinical practice and medical education with an emphasis on patient-centered care, shared decision making, and health equityEmerging therapies on the horizon and priority areas for future research Tune in to hear expert insights on how this updated, evidence-based resource can support better clinical decision making and improve patient outcomes.
In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA guideline on complicated urinary tract infection (cUTI), which was published a few months ago [1]. Together, they discuss the process of developing the guideline from its conception in 2018, the new definition of cUTI, their stepwise approach to clinical decision-making, and some case-by-case scenarios for common antibiotics. They also elaborate on how this guideline compares (and contrasts) to other existing UTI guidelines—including the previous IDSA guideline for UTI [2] —and the clinical need to supply frontline clinicians to identify and distinguish complicated cases from the uncomplicated ones. The episode closes with what essential clinical questions the guests hope to tackle next. This episode was edited by Kathryn Hostettler and peer reviewed by Maria Ana Flores of Santa Maria Local Health Unit, Lisbon, Portugal.Other resources:European Urologic Association guidelinesUpToDateFDA guidance on complicated UTI ReferencesTrautner BW, et al. Clinical Practice Guideline by Infectious Diseases Society of America (IDSA): 2025 Guideline on Management and Treatment of Complicated Urinary Tract Infections Gupta, K, et al. Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: 2010 Update by IDSA
Un nouvel épisode du Pharmascope est disponible! Dans ce 87ème épisode, deuxième de la série sur l'insomnie, Nicolas, Sébastien et Isabelle tentent de vous maintenir éveillés en discutant du traitement pharmacologique de l'insomnie. Les objectifs pour cet épisode sont les suivants: Comparer les traitements pharmacologiques de l'insomnie Expliquer les bénéfices et les risques des traitements pharmacologiques de l'insomnie Discuter des avantages et des inconvénients de chacun des traitements pharmacologiques de l'insomnie Ressources pertinentes en lien avec l'épisode Publications de l'American Academy of Sleep Medicine Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17:255-62. Edinger JD et coll. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17:263-98. Sateia MJ et coll. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13:307-49. Lignes directrices du U.S. Department of Veterans Affairs and U.S Department of Defense Mysliwiec V et coll. The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Ann Intern Med. 2020;172:325-36. Publications de l'American College of Physicians Qaseem A et coll. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;165:125-33. Wilt TJ et coll. Pharmacologic Treatment of Insomnia Disorder: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Ann Intern Med. 2016;165:103-12. Outil: Index de Sévérité de l'Insomnie Morin, C. Index de Sévérité de l'Insomnie. Centre d'étude des troubles du sommeil. Université Laval.
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Marc Pelletier, division chief of cardiac surgery for the Department of Surgery at Yale School of Medicine, about patient blood management. Chapters 00:00 Intro 01:45 EACTS 2025 07:19 JANS 1, HVD Management Guidelines 16:26 JANS 2, Low-Risk AVR Evidence 19:21 JANS 3, Warden Procedure Selection 20:36 JANS 4, Primary Repair of CAT 21:48 JANS 5, NEWTON-CABG Cardiolink-5 23:20 Video 1, Acute Aortic Syndrome 24:54 Video 2, Redo TVR Under Bypass 27:13 Video 3, Giant Tension Bulla 28:47 Dr. Pelletier Interview 34:25 Outro They delve into the Society of Thoracic Surgeons (STS) guidelines on patient blood management, along with key tips. They also explore preoperative optimization, provide an example, and discuss cell savers and reducing dead space during surgery. Additionally, they touch on postoperative transfusion and the importance of performing meticulous surgery. Joel also highlights recent JANS articles on the 2025 ESC/EACTS guidelines for the management of valvular heart disease, low-risk aortic valve replacement at the crossroads of evidence, ideal age and weight for the Warden procedure in patients with partial anomalous pulmonary venous return, a systematic meta-analysis of short- and long-term outcomes of the primary repair of common arterial trunk, and an international, randomized, double-blind, placebo-controlled trial on the effect of Evolocumab on saphenous vein graft patency after coronary artery bypass surgery. In addition, Joel explores the surgical treatment of acute aortic syndrome, a redo tricuspid valve replacement technique under right heart bypass for a previously repaired tricuspid valve, and thoracoscopic resection of a giant tension bulla. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 1.) 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease: Developed by the Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) 2.) Low-Risk Aortic Valve Replacement at the Crossroads of Evidence 3.) Is There an Ideal Age or Weight for the Warden Procedure in Patients With Partial Anomalous Pulmonary Venous Return? 4.) Primary Repair of Common Arterial Trunk: A Systematic Meta-Analysis of Short- and Long-Term Outcomes 5.) Effect of Evolocumab on Saphenous Vein Graft Patency After Coronary Artery Bypass Surgery (NEWTON-CABG CardioLink-5): An International, Randomized, Double-Blind, Placebo-Controlled Trial CTSNet Content Mentioned 1.) Surgical Treatment of Acute Aortic Syndrome 2.) Redo Tricuspid Valve Replacement Technique Under Right Heart Bypass for a Previously Repaired Tricuspid Valve 3.) Thoracoscopic Resection of a Giant Tension Bulla Other Items Mentioned 1.) STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management 2.) Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients: An Updated Meta-Analysis of Randomized Controlled Trials 3.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 4.) Career Center 5.) CTSNet Events Calendar Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.
Maddy presents a fascinating case of dyspnea with diffuse ground-glass opacities. Tune in as Mark, Youssef, and Noah work through the diagnostic puzzle. GGOs Schema Bird + Lung Ddx References: NEJM CPC: Hypoxemia at the Bedside — https://www.nejm.org/doi/full/10.1056/NEJMcpc2004991 JAMA 2024: Pneumonia — https://jamanetwork.com/journals/jama/article-abstract/2823762 ATS 2025: Clinical Practice Guideline on the Management of Community-Acquired Pneumonia —… Read More »Episode 425: Schema Episode – Ground Glass Opacities
JAMAevidence Users' Guide to the Medical Literature: Using Evidence to Improve Care
Thomas Agoritsas, MD, PhD, Geneva University Hospitals, Switzerland discusses Users' Guides to the Medical Literature about patient management recommendations with author Gordon H. Guyatt, MD, MSc, McMaster University. Related Content: How to Interpret and Use a Clinical Practice Guideline or Recommendation Platelet Transfusion Caring for Patients With Acute Respiratory Distress Syndrome
In this episode, Katlyn Moss talks to guest speakers Aimee Feste, CNM and Kiran Sigmon, MD, who will dive into the challenges and treatment options surrounding perimenopause and menopause, offering practical advice for healthcare providers and women navigating these life stages. They also share some information on hormone testing limitations, the role of hormone therapy, non-hormonal treatments, and key resources available for healthcare providers and patients.Resources The Menopause Society https://menopause.org/ Books/Podcasts:“The Menopause Manifesto” Dr. Jen Gunter “You are not broken” Podcast and book. Dr. Casperson board certified urologist“Hit play not pause” Athlete perspective podcast“Come as you are” Podcast and book as well as new book “Come Together” Emily Nagoski PhD sexual health researcherTestosterone info: Article: ISWISH (International Society for the student of Women's Sexual health) has a great website. https://www.isswsh.org/ They have article: “Clinical Practice Guideline for the Use of Systemic Testosterone for HSDD published” https://www.auanet.org/about-us/media-center/press-center/american-urological-association-releases-new-guideline-on-genitourinary-syndrome-of-menopause#:~:text=This%20Guideline%20includes%3A,%2C%20low%2Ddose%20vaginal%20estrogen.We would love your feedback on our podcast! Please take our listener survey to provide your comments.Follow us on FacebookFollow us on InstagramMusic credit: "Carefree" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/Please provide feedback here:https://redcap.mahec.net/redcap/surveys/?s=XTM8T3RPNK
“It's 5pm and your Consultant (attending) has headed off home. A patient arrives in the resuscitation room blood spurting from a stab wound in the armpit. Join Roisin – a junior Major Trauma fellow, Prash – a surgical trainee, Max – a senior trauma surgery fellow, and Chris – a Consultant trauma surgeon, as we talk through decision making from point of injury to aftercare in this challenging trauma surgical case”. • Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated 1. Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool 2. Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital. 3. Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83 4. Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin • Learning objectives: Bulleted list of learning objectives. A) To become familiar with prehospital methods of haemorrhage control in penetrating junctional injuries. B) To recognise the benefits of prehospital blood product resuscitation in some trauma patients. C) To follow the nuanced decision making in decision for CT scan in a patient with a penetrating junctional injury. D) To describe the possible approaches to the axillary artery in the context of resuscitative trauma surgery. E) To become familiar with decision making around intraoperative systemic anticoagulation in the trauma patient. F) To become familiar with decision making on type of repair and graft material in vascular trauma. G) To recognise the team approach in holistic trauma care through the continuum of trauma care. • References: Bulleted list of references with PubMed links. 1. Perkins Z. et al., 2012. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. EJVES. https://www.ejves.com/article/S1078-5884(12)00337-1/fulltext 2. Ramaraj P., et al. 2025. The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study. Injury. https://www.injuryjournal.com/article/S0020-1383(24)00771-X/ 3. Smith, S., et al. 2019. The effectiveness of junctional tourniquets: A systematic review and meta-analysis. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/abstract/2019/03000/the_effectiveness_of_junctional_tourniquets__a.20.aspx 4. Rijnhout TWH, et al. 2019. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury. https://www.injuryjournal.com/article/S0020-1383(19)30133-0/ 5. Davenport R, et al. 2023. Prehospital blood transfusion: Can we agree on a standardised approach? Injury. https://www.injuryjournal.com/article/S0020-1383(22)00915-9. 6. Borgman MA., et al. 2007. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/fulltext/2007/10000/the_ratio_of_blood_products_transfused_affects.13.aspx 7. Holcomb JB., et al. 2013. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. Comparative Effectiveness of a Time-Varying Treatment With Competing Risks. JAMA Surgery. https://jamanetwork.com/journals/jamasurgery/fullarticle/1379768 8. Holcomb JB, et al. 2015. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma. The PROPPR Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2107789 9. Davenport R., et al. 2023. Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury. The CRYOSTAT-2 Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2810756 10. Baksaas-Aasen K., et al. 2020. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. ICM. https://link.springer.com/article/10.1007/s00134-020-06266-1 11. Wahlgren CM., et al. 2025. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. EJVES. https://esvs.org/wp-content/uploads/2025/01/2025-Vascular-Trauma-Guidelines.pdf 12. Khan S., et al. 2020. A meta-analysis on anticoagulation after vascular trauma. Eur J Traum Emerg Surg. https://link.springer.com/article/10.1007/s00068-020-01321-4 13. Stonko DP., et al. 2022. Postoperative antiplatelet and/or anticoagulation use does not impact complication or reintervention rates after vein repair of arterial injury: A PROOVIT study. Vascular. https://journals.sagepub.com/doi/10.1177/17085381221082371?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
In this episode, we review the newly published 2025 ACC/AHA hypertension guidelines. Key Concepts Instead of the Pooled Cohort Equations (PCE) from 2013, the 2025 hypertension guidelines recommend a new risk equation called PREVENT, which incorporates new risk factors and does not include race as part of the risk calculation. The guidelines recommend starting two antihypertensive medications for initial therapy in stage II hypertension and one antihypertensive medication for stage I hypertension. The guidelines no longer recommend specific first-line therapies for black patients. Instead, all patients without compelling indications should be initiated on a thiazide, ACE inhibitor, ARB, or dihydropyridine calcium channel blocker regardless of race/ethnicity. All patients should have a blood pressure goal of < 130/80 mmHg. Some patients may consider a more stringent goal of < 120/80 if they have diabetes or are at a higher risk of future ASCVD events. References Jones DW, Ferdinand KC, Taler SJ, Johnson HM, Shimbo D, Abdalla M, Altieri MM, Bansal N, Bello NA, Bress AP, Carter J, Cohen JB, Collins KJ, Commodore-Mensah Y, Davis LL, Egan B, Khan SS, Lloyd-Jones DM, Melnyk BM, Mistry EA, Ogunniyi MO, Schott SL, Smith SC Jr, Talbot AW, Vongpatanasin W, Watson KE, Whelton PK, Williamson JD. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025 Aug 14. doi: 10.1161/CIR.0000000000001356. Epub ahead of print. PMID: 40811497.
Send us a message with this link, we would love to hear from you. Standard message rates may apply.The flu vaccine is our best defense against influenza, a contagious respiratory virus that causes millions of illnesses and thousands of deaths in the US each year. Despite being only 40-60% effective, the vaccine significantly reduces hospitalizations, outpatient visits, and deaths while protecting vulnerable populations who cannot be vaccinated.• Influenza causes 9-41 million illnesses, 140,000-960,000 hospitalizations, and 12,000-80,000 deaths annually in the US• Everyone aged six months and older should receive the flu vaccine yearly• The vaccine must be updated annually because the flu virus changes each year• Getting vaccinated helps protect vulnerable populations like infants and immunocompromised individuals• Common misconception that the vaccine causes flu is false – it cannot give you the flu• Only 40-46% of Americans get the flu vaccine annually despite its proven benefits• The best time to get vaccinated is before flu season begins, but getting it later still helps• Flu vaccination reduces strain on hospitals during peak seasonsGo get your flu shot today! It's the best way to protect yourself, your loved ones, and your neighbors ReferencesPrevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 Influenza Season. Grohskopf LA, Blanton LH, Ferdinands JM, et al. MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 2022;71(1):1-28. doi:10.15585/mmwr.rr7101a1. Copyright License: CC0.Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2019;68(6):e1-e47. doi:10.1093/cid/ciy866.Influenza Vaccination. Treanor JJ. The New England Journal of Medicine. 2016;375(13):1261-8. doi:10.1056/NEJMcp1512870.Effects of Influenza Vaccination in the United States During the 2017-2018 Influenza Season. Rolfes MA, Flannery B, Chung JR, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2019;69(11):1845-1853. doi:10.1093/cid/ciz075.Vaccines for Preventing Influenza in Healthy Adults. Demicheli V, Jefferson T, Ferroni E, Rivetti A, Di Pietrantonj C. The Cochrane Database of Systematic Reviews. 2018;2:CD001269. doi:10.1002/14651858.CD001269.pub6.Recommendations for Prevention and Control of Influenza in Children, 2022-2023. Pediatrics. 2022;150(4):e2022059275. doi:10.1542/peds.2022-059275.Influenza. Uyeki TM. Annals of Internal Medicine. 2021;174(11):ITC161-ITC176. doi:10.7326/AITC202111160.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is live! Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice. Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider. ------------------------------ RESOURCES Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall) ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005 Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/ TENDINopathy Severity Assessment - Achilles (TENDINS-A) outcome measure: https://www.jospt.org/doi/10.2519/jospt.2023.11964
A silent danger lurks within the descending thoracic aorta. While most Type B aortic dissections are managed medically, up to half of these patients will either require life-saving surgery or die within just five years. So how do we separate those who will quietly recover from those on the edge of catastrophe? How do we protect the spinal cord, bowel, and limbs from the devastating consequences of malperfusion? Join the University of Michigan Department of Vascular Surgery as they tackle the high-stakes decisions behind managing this unpredictable disease—where timing is critical, interventions are evolving, and lives hang in the balance. Hosted by the University of Michigan Department of Vascular Surgery: · Robert Beaulieu, Program Director · Frank Davis, Assistant Professor of Surgery · Luciano Delbono, PGY-5 House Officer · Andrew Huang, PGY-4 House Officer · Carolyn Judge, PGY-2 House Officer Learning Objectives: 1. Discuss general approach to diagnosis and management of TBAD. 2. Identifying high-risk features in uncomplicated TBAD and understanding their role in determining the need for surgical management. 3. Review endovascular techniques for managing malperfusion of the limbs, viscera, and spinal cord and discuss associated decision making. References: Authors/Task Force Members, Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., Kim, K. M., Kreibich, M., Lescan, M., Di Marco, L., Martens, A., Mestres, C. A., Milojevic, M., Nienaber, C. A., … Hughes, G. C. (2024). EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. The Annals of Thoracic Surgery, 118(1), 5–115. https://doi.org/10.1016/j.athoracsur.2024.01.021 de Kort, J. F., Hasami, N. A., Been, M., Grassi, V., Lomazzi, C., Heijmen, R. H., Hazenberg, C. E. V. B., van Herwaarden, J. A., & Trimarchi, S. (2025). Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection. Annals of Vascular Surgery, S0890-5096(25)00004-4. https://doi.org/10.1016/j.avsg.2024.12.060 Eidt, J. F., & Vasquez, J. (2023). Changing Management of Type B Aortic Dissections. Methodist DeBakey Cardiovascular Journal, 19(2), 59–69. https://doi.org/10.14797/mdcvj.1171 Lombardi, J. V., Hughes, G. C., Appoo, J. J., Bavaria, J. E., Beck, A. W., Cambria, R. P., Charlton-Ouw, K., Eslami, M. H., Kim, K. M., Leshnower, B. G., Maldonado, T., Reece, T. B., & Wang, G. J. (2020). Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections. Journal of Vascular Surgery, 71(3), 723–747. https://doi.org/10.1016/j.jvs.2019.11.013 MacGillivray, T. E., Gleason, T. G., Patel, H. J., Aldea, G. S., Bavaria, J. E., Beaver, T. M., Chen, E. P., Czerny, M., Estrera, A. L., Firestone, S., Fischbein, M. P., Hughes, G. C., Hui, D. S., Kissoon, K., Lawton, J. S., Pacini, D., Reece, T. B., Roselli, E. E., & Stulak, J. (2022). The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection. The Annals of Thoracic Surgery, 113(4), 1073–1092. https://doi.org/10.1016/j.athoracsur.2021.11.002 Papatheodorou, N., Tsilimparis, N., Peterss, S., Khangholi, D., Konstantinou, N., Pichlmaier, M., & Stana, J. (2025). Pre-Emptive Endovascular Repair for Uncomplicated Type B Dissection—Is This an Option? Annals of Vascular Surgery, S0890-5096(25)00007-X. https://doi.org/10.1016/j.avsg.2025.01.003 Trimarchi, S., Gleason, T. G., Brinster, D. R., Bismuth, J., Bossone, E., Sundt, T. M., Montgomery, D. G., Pai, C.-W., Bissacco, D., de Beaufort, H. W. L., Bavaria, J. E., Mussa, F., Bekeredjian, R., Schermerhorn, M., Pacini, D., Myrmel, T., Ouzounian, M., Korach, A., Chen, E. P., … Patel, H. J. (2023). Editor's Choice - Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 66(6), 775–782. https://doi.org/10.1016/j.ejvs.2023.05.015 Writing Committee Members, Isselbacher, E. M., Preventza, O., Hamilton Black Iii, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Jones, W. S., Kalahasti, V., … Woo, Y. J. (2022). 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 80(24), e223–e393. https://doi.org/10.1016/j.jacc.2022.08.004 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Contributor: Taylor Lynch, MD Educational Pearls: What is atrial fibrillation with rapid ventricular response (AFib with RVR) and how does it differ from atrial fibrillation (AFib)? AFib is an abnormal heart rhythm in which the heart has disorganized atrial electrical activity. This causes the atria to quiver with only select signals being conducted through the Atrioventricular (AV) Node to reach the ventricles and result in ventricular contraction. Often described as “irregularly irregular”, a patient's EKG will present with no discernible P-waves, and irregular R-R intervals. AFib with RVR is distinguished from AFib when the patient's ventricular rate is greater than 100-110 beats per minute in AFib with RVR. What is the treatment for AFib with RVR? Diltiazem is considered one of the first line therapeutic agents in the treatment of AFib with RVR. Diltiazem inhibits L-Type calcium channels in the AV Node, reducing the amount of signals conducted to the ventricles, thus reducing the ventricular rate. Why pretreat patients receiving Diltiazem for AFib with RVR with calcium? While diltiazem inhibits cardiac calcium channels, it may also cause peripheral vasodilation, resulting in diltiazem-induced hypotension. A recent study found that this hypotension can be blunted by pretreating with 1-2g IV Calcium Chloride (IV Calcium Gluconate can be used in the ED). Calcium is thought to peripherally stabilize the vascular smooth muscle, preventing vasodilation without impacting the desired calcium channel blocker action at the AV node. Key takeaways? In combination with slower pushes of diltiazem for patients in AFib with RVR (AFib with ventricular rate >100-110 bpm) with borderline low blood pressures, 1-2 g of IV Calcium Gluconate can combat diltiazem induced hypotension peripherally without negating the cardiac effect of diltiazem to reduce the heart rate. References 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193 Az A, Sogut O, Dogan Y, et al. Reducing diltiazem-related hypotension in atrial fibrillation: Role of pretreatment intravenous calcium. Am J Emerg Med. 2025;88:23-28. doi:10.1016/j.ajem.2024.11.033 Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan and Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/
Ênio Macedo e Joanne Alves convidam Eduarda Guedes e Mariana Tourinho, R2 CM do HCMFMUSP, para discutir sobre 7 armadilhas na Doença arterial periférica (DAP), antiga DAOP.1. Não reconhecer manifestações clínicas iniciais 2. Valorizar somente o exame físico e não realizar o ITB 3. Solicitar exame de imagem no diagnóstico4. Focar apenas no tratamento farmacológico5. Não usar os tratamentos farmacológicos disponíveis6. Não reconhecer o momento de indicar revascularização7. Não reconhecer isquemia de membro agudaReferências: 1. https://www.tadeclinicagem.com.br/guia/324/doenca-arterial-obstrutiva-periferica-diretriz-ahaacc-2024/2. Gornik, Heather L et al. “2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation vol. 149,24 (2024): e1313-e1410. doi:10.1161/CIR.00000000000012513. Khan, Nadia A et al. “Does the clinical examination predict lower extremity peripheral arterial disease?.” JAMA vol. 295,5 (2006): 536-46. doi:10.1001/jama.295.5.5364. Londero, Louise S et al. “Pulse palpation is an effective method for population-based screening to exclude peripheral arterial disease.” Journal of vascular surgery vol. 63,5 (2016): 1305-10. doi:10.1016/j.jvs.2015.11.044
Editor-in-Chief Cecelia E. Schmalbach, MD, MSc is joined by co-authors Marc G. Dubin, MD, and Spencer C. Payne, MD, to discuss the Clinical Practice Guideline "Adult Sinusitis Update,” which published as a supplement to the August 2025 issue of Otolaryngology–Head and Neck Surgery. The guideline addresses diagnostic accuracy for adult rhinosinusitis, use of ancillary tests to confirm diagnosis and guide management, and systemic and topical therapy. Click here to read the full article.
Clinical Practice Guidelines (CPGs) are an incredible resource for clinicians of all experience levels—synthesizing all the research on a topic and packaging it into bite-sized recommendations and flow charts. But how often are clinicians adhering to these guidelines? In today's episode, Dr Maggie Horn (Duke University) walks us through her research team's work to assess if, how, and when clinicians follow CPG recommendations. The team worked with clinicians in their hospital system to embed templates in the EMR, and used self-report strategies to answer these questions, specifically for the neck pain CPG. Dr Horn reviews the neck pain CPG, how the research team evaluated adherence, and what the findings mean for CPGs and clinicians. ------------------------------ RESOURCES Neck pain clinical practice guideline (revised in 2017): https://www.jospt.org/doi/10.2519/jospt.2017.0302 Translating the neck pain CPG into practice framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0101
Today, we explore why naming matters—especially when it comes to peripheral nervous system disorders in autoimmune diseases like Sjögren's. Dr. Shanmugam is joined by Dr. Ghaith Noaiseh and Kathy Hammitt, two key contributors to the recently published manuscript, "Recommendations for Aligned Nomenclature of Peripheral Nervous System Disorders Across Rheumatology and Neurology," in Arthritis & Rheumatology. Together, they discuss the critical importance of unified terminology across specialties, the implications for diagnosis and treatment, and how clearer, consistent language can empower both clinicians and patients. The conversation also delves into the development of Clinical Practice Guidelines and how this nomenclature effort supports interdisciplinary care, research, and patient advocacy. Tune in for expert insight and a behind-the-scenes look at a major collaborative effort to bring clarity to complex clinical conversations.
In this episode, Dr. Sergio Zanotti discusses the different aspects of managing pneumonia in critically ill patients. He covers the initial management of severe pneumonia, management of ventilator-associated pneumonia, and highlights the clinical approach to non-resolving pneumonia in the intensive care unit (ICU). He is joined by Dr. Andre Kalil, a physician specializing in critical care and infectious diseases. Dr. Kalil is a Professor in the Division of Infectious Diseases and Director of Transplant Infectious Diseases at the University of Nebraska Medical Center (UNMC). Additional resources: How to approach a patient hospitalized for pneumonia who is not responding to treatment? Pedro Povoa, et al. Intensive Care Med 2025: https://link.springer.com/article/10.1007/s00134-025-07903-3 Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Andre Kalil, et al. Clin Infect Dis. 2016: https://pmc.ncbi.nlm.nih.gov/articles/PMC4981759/ Management of Ventilator-Associated Pneumonia: Guidelines. M Metersky and Andre c. Kalil. Infect Dis Clin North Am. 202: https://pubmed.ncbi.nlm.nih.gov/38280768/ Hydrocortisone in Severe Community-Acquired Pneumonia. CAPE-COD Clinical Trial. N Eng J of Med 202: https://www.nejm.org/doi/full/10.1056/NEJMoa2215145 Continuous vs. Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients with Sepsis. BLING III Clinical Trial. JAMA 2024: https://jamanetwork.com/journals/jama/fullarticle/2819971 Music mentioned in this episode: Pat Metheny Group – We Live Here: https://bit.ly/44gt8Jl Antonio Carlos Jobin – Terra Basilis: http://bit.ly/4k4Amq1 Mahler: Symphony No.9 – Chicago Symphony Orchestra: http://bit.ly/4k9sXWn
Send us a textWelcome back Rounds Table Listeners! Today we have the next episode in our Clinical Practice Guidelines series. Drs. Mike and John Fralick discuss the top takeaways from the 2024 KDIGO Clinical Practice Guidelines for chronic kidney disease. Here we go!1. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (0:00 - 24:24)Access the KDIGO 2024 "Top 10 Takeaways" PDFs here: https://kdigo.org/guidelines/ckd-evaluation-and-management/The Good Stuff:Nephrology Trial Files - https://nephrotrialfiles.substack.com/ (24:25 - 24:48)The Phoenician Scheme (24:49 - 25:33)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods
Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits Journal of General Internal Medicine The American Society of Addiction Medicine (ASAM), in collaboration with nine other medical societies and professional associations, developed evidence-based guidelines for tapering benzodiazepine (BZD) medications across various clinical settings. These guidelines were created using a modified GRADE methodology and a clinical consensus process, which included a systematic literature review and several targeted supplemental searches. The guidelines were also revised based on feedback from external stakeholders. Key recommendations include that clinicians should continually assess the risks and benefits of BZD use and tapering. They should engage in shared decision-making with patients and avoid abrupt discontinuation in individuals who may be physically dependent or at risk of withdrawal. Tapering strategies should be personalized and adjusted based on the patient's response. Additionally, clinicians are encouraged to provide psychosocial support to help patients successfully taper off BZDs. Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM
In this episode of Voices of Otolaryngology, Jeffrey S. Weingarten, MD, shares insights on creating a thriving otolaryngology practice that serves as a true "one-stop shop" for ENT care. Learn how his Detroit-area practice successfully integrates 11 physicians, 17 audiologists, and specially trained staff across six locations. Dr. Weingarten discusses the innovative Certificate Program for Otolaryngology Personnel (CPOP), which trains "OTO Techs" to perform hearing tests, maximizing efficiency while allowing audiologists to work at the top of their license. Discover the benefits of team-based care, billing approaches, operational strategies, and how similar models can be implemented in other practices. The conversation with Rahul K. Shah, MD, MBA, AAO-HNS/F Executive Vice President and CEO, offers valuable insights on enhancing patient care while building a sustainable practice model. Resources: Certificate Program of Otolaryngology Personnel: https://www.entnet.org/event/aao-hnsf-certificate-program-for-otolaryngology-personnel-cpop-workshop/ Clinical Practice Guidelines: https://www.entnet.org/cpg/ Optimizing Audiology and Hearing Aid Ancillaries: https://bulletin.entnet.org/professional-personal-development/article/22909473/optimizing-audiology-and-hearing-aid-ancillaries More Ways to Listen: Spotify: https://open.spotify.com/show/3UeVLtFdLHDnWnULUPoiin Apple Podcasts: https://podcasts.apple.com/us/podcast/voice-of-otolaryngology/id1506655333 Connect the AAO-HNS: Instagram: https://www.instagram.com/aaohns X (Twitter): https://x.com/AAOHNS Facebook: https://www.facebook.com/AAOHNS LinkedIn: https://www.linkedin.com/company/american-academy-of-otolaryngology/ Website: https://www.entnet.org Shop AAO-HNS Merchandise: https://www.otostore.org Help Us Improve Future Episodes: Share your feedback and topic suggestions at https://forms.office.com/r/0XpA83XNBQ Subscribe to Voices of Otolaryngology for more insights from leading voices in ENT. New episodes released every Tuesday.
Editor-in-Chief Cecelia E. Schmalbach, MD, MSc, is joined by authors Meghan Wilson, MD, and Jason Blakeley Hensler, MD, to discuss information on when to consider moving forward with surgical interventions for those who are evaluated and diagnosed with chronic rhinosinusitis. Based on the 2025 “Clinical Practice Guideline: Surgical Management of Chronic Rhinosinusitis” and is a companion publication to the full guideline. Click here to read the full article.
Ever consider specializing deeper into an aspect of neuro? Wonder what it's like to dive deep into a subset of the neuro population and sharpen your practice? In today's show, host Erin Gallardo, PT, DPT, NCS interviews Andrew Doubek, PT, DPT, GCS, NMD about his recent experience going through an accredited movement disorders fellowship program at the Ohio State. In the show we talk about the details of what the fellowship was like from the schedule, mix of experiences, requirements and types of patients. Andrew shares his insights and words of wisdom to anyone considering a fellowship. Plus, with documentation efficiency being top of mind for so many clinicians, Andrew generously shares his handout of smart phrases crafted from the Clinical Practice Guidelines that you can plug into your assessments and progress notes to ensure you're targeting the key aspects needed in your notes in less time. Download the smart phrase guides here! PD CPG smartphrase.docx FND smartphrase.docx Core outcomes smart phrases.docx
Editor-in-Chief Cecelia E. Schmalbach, MD, MSc is joined by the guideline group's chair Jennifer J. Shin, MD, SM, and co-author Dana Crosby, MD, MPH, for a discussion of key points from the “Clinical Practice Guideline: Surgical Management of Chronic Rhinosinusitis,” which published as a supplement to the June 2025 issue of Otolaryngology–Head and Neck Surgery. The guideline addresses critical questions about patient selection, timing of surgery, and the extent of surgical intervention needed for different chronic rhinosinusitis subtypes. Read the full article here.
We are joined by physical therapists Saurabh Mehta and Christos Karagiannopoulos, who – along with a team of therapists and surgeons – developed a clinical practice guideline for rehabilitation following distal radius fractures. They share with us how a CPG is developed, how the evidence is synthesized and how they came to their conclusions based on the evidence to provide recommendations for evaluation, interventions and prognosis. Guest Bios: Dr. Karagiannopoulos is a full-time associate professor at DeSales University DPT program with a current line of research on the assessment and management of wrist sensorimotor control impairment. He has earned a Bachelor of Science, a Master of Education, and a Doctor of Philosophy in Kinesiology from Temple University. His master's in physical therapy was earned from MCP-Hahnemann University (Drexel University) in 1999. Christos has dedicated his 20+ years clinical practice in orthopedic physical therapy and the rehabilitation of the upper extremity as a Certified Hand Therapist. He has dedicated his clinical research line on the wrist sensorimotor control impairment, developing the active wrist joint position sense test and its psychometric properties. Dr. Karagiannopoulos has published his most recent research work in the Journal of Hand Therapy, and he co-authored the most recent 2024 APTA Clinical Practice Guidelines on distal radius fracture rehabilitation in the JOSPT. He has also co-authored the 2020 AAOS Clinical Practice Guidelines for distal radius fracture management. Dr. Karagiannopoulos has lectured at various local, national, and international symposiums. He currently serves on the APTA Academy of Hand & Upper Extremity as a program co-chair and a member of the research committee. He is also a member of the Journal of Hand Therapy editorial board.Dr. Mehta is a board-certified specialist in geriatric physical therapy and the Director of Research for the College of Health Sciences at East Tennessee State University. He has collaborated and published multiple data-based articles and systematic reviews in upper extremity rehabilitation, healthy aging, and improving physical functions in the elderly. Dr. Mehta recently led the efforts to develop ICF-based clinical practice guidelines for the rehabilitation of distal radius fractures. He is the chair of the Aging Research and Geriatric Rehabilitation Networking Group of the American College of Rehabilitation Medicine
This episode of the AARC Perspectives podcast discusses AARC's newest Clinical Practice Guideline on pediatric critical asthma with Lynda Goodfellow, EdD, RRT, FAARC, AARC Director of CPGs, and lead author Benjamin White, MD, MA, Assistant Professor of Pediatrics, Division of Pediatric Critical Care at the University of Utah. They discuss how this CPG was developed and summarize its recommendations, limitations, and why more research is needed. Additional ResourcesPediatric Critical Asthma CPGSend us a textSupport the show
Acesse o Guia de bolso de IOT do TdC no link: http://bit.ly/4dyi6n8Pedro Magno e Lucca Cirillo conversam sobre os alvos de LDL em 4 populações:- Evento cardiovascular prévio- Presença de diabetes- LDL > 190 mg/dL- Outras situações Veja mais em https://www.tadeclinicagem.com.br/guia/259/hipercolesterolemia-familiar/Veja o vale a pena ouvir de novo em https://www.youtube.com/watch?v=k42rmssU1xE&ab_channel=TadeClinicagemReferências:1. Mach, François et al. “2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.” European heart journal vol. 41,1 (2020): 111-188. doi:10.1093/eurheartj/ehz4552. Faludi, André Arpad et al. “Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017.” Arquivos brasileiros de cardiologia vol. 109,2 Supl 1 (2017): 1-76. doi:10.5935/abc.201701213. Grundy, Scott M et al. “2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.” Journal of the American College of Cardiology vol. 73,24 (2019): 3168-3209. doi:10.1016/j.jacc.2018.11.0024. Pearson, Glen J et al. “2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults.” The Canadian journal of cardiology vol. 37,8 (2021): 1129-1150. doi:10.1016/j.cjca.2021.03.0165. Marx, Nikolaus et al. “2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes.” European heart journal vol. 44,39 (2023): 4043-4140. doi:10.1093/eurheartj/ehad1926. Vrints, Christiaan et al. “2024 ESC Guidelines for the management of chronic coronary syndromes.” European heart journal vol. 45,36 (2024): 3415-3537. doi:10.1093/eurheartj/ehae1777. Hong, Sung-Jin et al. “Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial.” JAMA vol. 329,13 (2023): 1078-1087. doi:10.1001/jama.2023.24878. Cannon, Christopher P et al. “Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.” The New England journal of medicine vol. 372,25 (2015): 2387-97. doi:10.1056/NEJMoa14104899. Sabatine, Marc S et al. “Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.” The New England journal of medicine vol. 376,18 (2017): 1713-1722. doi:10.1056/NEJMoa161566410. http://departamentos.cardiol.br/sbc-da/2015/calculadoraer2017/etapa1.html11. Lipidology update: targets and timing of well-established therapies, Luigina Guasti 1, MD, PhD, FAHA, FESC; Alessandro Lupi 2, MD at https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/lipidology-update-targets-and-timing-of-well-established-therapies12. Ray, Kausik K et al. “EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study.” European journal of preventive cardiology vol. 28,11 (2021): 1279-1289. doi:10.1093/eurjpc/zwaa04713. Cholesterol Treatment Trialists' (CTT) Collaboration et al. “Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials.” Lancet (London, England) vol. 376,9753 (2010): 1670-81. doi:10.1016/S0140-6736(10)61350-5
The ICU Liberation Campaign from the Society of Critical Care Medicine (SCCM) has transformed critical care, but the COVID-19 pandemic and subsequent staffing challenges have posed major obstacles to maintaining progress. In this episode of the SCCM Podcast, host Ludwig H. Lin, MD, speaks with Juliana Barr, MD, FCCM, a key architect of the ICU Liberation Campaign. Dr. Barr was a lead author of the 2013 “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit,” known as the PAD guidelines, an original cornerstone of the ICU Liberation Campaign (Barr J, et al. Crit Care Med. 2013;41:263-306). The guidelines' recent 2025 update also addressed immobility and sleep disruption (Lewis K, et al. Crit Care Med. 2025;53:e711-e727). Dr. Barr shares her personal journey from traditional ICU practices of heavy sedation and immobility to leading efforts that prioritize patient recovery, well-being, and post-ICU quality of life. She emphasizes how ICU Liberation reintroduced low-tech, high-impact interventions such as minimizing sedation, promoting early mobility, and engaging families—leading to better outcomes at lower costs. She cites the 2017 international survey by Morandi et al that demonstrated uneven but steady improvements in global ICU Liberation practices before the pandemic (Morandi A, et al. Crit Care Med. 2017;45:e1111-e1122). Dr. Barr details the need for reeducation, multidisciplinary team engagement, and reworking electronic health record (EHR) systems to better support ICU Liberation goals. Looking forward, Dr. Barr offers a "burning platform" approach, stressing that delaying ICU Liberation practices risks poorer patient outcomes. She advocates for cultural change, leadership engagement, real-time metrics visibility, and hospital-wide investment—including IT support to surface buried ICU Liberation Bundle data within EHRs. By reframing ICU Liberation as a "team sport" and making best practices part of daily ICU culture, Dr. Barr believes institutions can reestablish the bundle's momentum and reconnect healthcare teams to their core mission—helping patients return to meaningful lives after critical illness. This conversation offers energizing, practical strategies for ICU teams at every stage of ICU Liberation implementation or reinvigoration.
Marcela Belleza e Raphael Coelho convidam Matheus Rezende, residente do último ano de Cardiologia - Incor, para conversar sobre manejo de doença coronariana crônica em tres tópicos:- Como realizar a investigação inicial?- Como fazer a terapia medicamentosa inicial?- O que fazer com o paciente que não melhora?Referências: 1. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes [published correction appears in Eur Heart J. 2025 Feb 21:ehaf079. doi: 10.1093/eurheartj/ehaf079.]. Eur Heart J. 2024;45(36):3415-3537. doi:10.1093/eurheartj/ehae1772. Virani, Salim S et al. “2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” Circulation vol. 148,9 (2023): e9-e119. doi:10.1161/CIR.00000000000011683. Montone RA, Rinaldi R, Niccoli G, et al. Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions. J Am Coll Cardiol. 2024;84(8):744-760. doi:10.1016/j.jacc.2024.06.0154. Mortensen MB, Dzaye O, Steffensen FH, et al. Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. J Am Coll Cardiol. 2020;76(24):2803-2813. doi:10.1016/j.jacc.2020.10.0215. Doenst T, Haverich A, Serruys P, et al. PCI and CABG for Treating Stable Coronary Artery Disease: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;73(8):964-976. doi:10.1016/j.jacc.2018.11.0536. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020;382(15):1395-1407. doi:10.1056/NEJMoa19159227. Rajkumar CA, Foley MJ, Ahmed-Jushuf F, et al. A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina. N Engl J Med. 2023;389(25):2319-2330. doi:10.1056/NEJMoa23106108. Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319-1330. doi:10.1056/NEJMoa17091189. Howlett JG, Stebbins A, Petrie MC, et al. CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial. JACC Heart Fail. 2019;7(10):878-887. doi:10.1016/j.jchf.2019.04.01810. Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-1847. doi:10.1056/NEJMoa202137211. Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(15):1503-1516. doi:10.1056/NEJMoa07082912. Ford TJ, Stanley B, Good R, et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J Am Coll Cardiol. 2018;72(23 Pt A):2841-2855. doi:10.1016/j.jacc.2018.09.00613. Carvalho, Tales de et al. “Brazilian Cardiovascular Rehabilitation Guideline - 2020.” “Diretriz Brasileira de Reabilitação Cardiovascular – 2020.” Arquivos brasileiros de cardiologia vol. 114,5 (2020): 943-987. doi:10.36660/abc.20200407
Send us a textToday we're introducing a new format—the first episode in our Clinical Practice Guidelines series. This week, Drs. Mike and John Fralick discuss the 2025 ACC/AHA Clinical Practice Guidelines for Acute Coronary Syndrome. Here we go! Support the show
Send us a textWelcome back Rounds Table Listeners! Today we're introducing a new format—the first episode in our Clinical Practice Guidelines series. This week, Drs. Mike and John Fralick discuss the 2025 ACC/AHA Clinical Practice Guidelines for Acute Coronary Syndrome. Here we go!2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes (0:00 - 18:56)Mike's interview with Dr. Jeff Carson:Episode 110 - Restrictive versus Liberal Transfusion in Myocardial Infarction with Dr. Jeff CarsonThe Good Stuff:Egg cracking tips! (18:57 - 19:47)Jerro (19:48 - 20:47)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods
In this episode, Dr. Zanotti discussed the Society of Critical Care Medicine “Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU." This is also known as the PADIS Guidelines. He is joined by Joanna L. Stollings, PharmD, a Board-Certified Pharmacotherapy Specialist and a Board-Certified Critical Care Pharmacotherapy Specialist. Joanna is the Medical Intensive Care Unit (MICU) Clinical Pharmacy Specialist at the Vanderbilt University Medical Center. She also served as vice chair for the PADIS Guideline Focused Update and co-authored the guidelines. Additional resources: Society of Critical Care Medicine Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2025 Update: https://pubmed.ncbi.nlm.nih.gov/39982143/ Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2018 Guidelines: https://pubmed.ncbi.nlm.nih.gov/30113379/ Link to a previous episode of Critical Matters discussing the PADIS 2018 Guidelines: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=635606964 Landing page for the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center: https://www.icudelirium.org/ Books mentioned in this episode: The Prophet. By Kahlil Gibran: https://bit.ly/4lA2Jhx
Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in EMS? Could standing a patient to check their heart rate actually be harmful? Join the podcast crew as they address these questions and more. REFERENCES 1. White, JL, Hollander, JE, Chang, AM, et al. (2019). Orthostatic vital signs do not predict 30-day serious outcomes in older emergency department patients with syncope: A multicenter observational study. The American journal of emergency medicine, 37(12), 2215–2223. 2. Shen W, Sheldon R, Yancy C, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of The American College Of Cardiology. August 1, 2017;70(5):e39-e110. Available from: MEDLINE, Ipswich, MA. Accessed May 1, 2018. 3. Cohen E, Grossman E, Sapoznikov B, et al. Assessment of orthostatic hypotension in the emergency room. Blood Press. 2006;15(5):263-267. 4. Aronow WS, Lee NH, Sales FF, Etienne F. Prevalence of postural hypotension in elderly patients in a long-term health care facility. Am J Cardiol. 1988;62(4):336. 5. Ooi WL, Barrett S, Hossain M, et al. Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population. JAMA. 1997;277(16):1299-1304.
On this episode we review the 2025 Clinical Practice Guideline for the Pharmacologic Management of Adults with Dyslipidemia published by the American Association of Clinical Endocrinology. We compare and contrast the common medications used in the management of dyslipidemia and examine how these can be utilized based on the 13 updated recommendations found in the 2025 guidelines. Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below: www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast.. You can get a copy of HPM at the links below: Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/ If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com
Dr. John Fleetham chats with Dr. Sonal Munsiff and Dr. Raquel Duarte about their article, "Updates on the Treatment of Drug-Susceptible and Drug-Resistant Tuberculosis: An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline."
In this episode of the Aaron Werner Podcast, Dr. Aaron Werner is joined by Dr. Carl Urbanski and Dr. Andy Morgenstern—two key leaders behind the AOA's Evidence-Based Optometry Committee. Together, they pull back the curtain on the Clinical Practice Guidelines (CPGs) that shape how optometrists diagnose and manage disease. What You'll Learn: • What the AOA Clinical Practice Guidelines really are—and why they matter • The 14-step, evidence-first process behind each guideline • How to use CPGs in real-world clinical settings to improve patient care • Why prevalence data should change how you see your schedule • The difference between “great pickups” and just doing your job well • Why CPGs are NOT influenced by industry or billing priorities—only evidence • How students, staff, and even patients can benefit from engaging with guidelines To access the AOA Clinical Practice Guidelines (Free Access) CLICK HERE (https://www.aoa.org/practice/clinical-guidelines/clinical-practice-guidelines?sso=y) Whether you're in private practice, academia, or a hospital system, this episode is packed with insights on how to be a better doctor, not just a busier one. Share with your team or students—this episode is a must-listen for anyone who wants to elevate care through clinical clarity. ________________________ questions@eyecode-education.com Go to MacuHealth.com and use the coupon code PODCAST2024 at checkout for special discounts Let's Connect! Follow and join the conversation! Instagram: @aaron_werner_vision
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
Send us a textIn this episode, we have Dr. Lisa Dubrofsky (Nephrology, University of Toronto) speaking about the KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.Host: Dr. Catherine Leurer (Geriatrics Fellow)Sound editing by: Krzystof KowalikSupport the show
Chris Hughen sat down with Ruth Chimenti to discuss Achilles Tendinopathy. We dive into the recently revised Clinical Practice Guideline on mid portion achilles tendinopathy, treatment options, continued uncertainties, common misconceptions, and much more. Watch the full episode: https://youtu.be/qNUow-leX5Q Episode Resources: Midportion Achilles Tendinopathy CPG Previous Episode on Achilles Tendinopathy: #93 w/ Karin Silbernagel --- Follow Us: YouTube: https://www.youtube.com/e3rehab Instagram: https://www.instagram.com/e3rehab/ Twitter: https://twitter.com/E3Rehab --- Rehab & Performance Programs: https://store.e3rehab.com/ Newsletter: https://e3rehab.ck.page/19eae53ac1 Coaching & Consultations: https://e3rehab.com/coaching/ Mentoring: https://e3rehab.com/mentorship-intake-form/ Articles: https://e3rehab.com/articles/ --- Podcast Sponsors: Legion Athletics: Get 20% off using "E3REHAB" at checkout! - https://legionathletics.rfrl.co/wdp5g Vivo Barefoot: Get 15% off all shoes! - https://www.vivobarefoot.com/e3rehab Tindeq: Get 10% off your dynamometer using code “E3REHAB” at checkout - https://tindeq.com/ --- @dr.surdykapt @tony.comella @dr.nicolept @chrishughen @nateh_24 --- This episode was produced by Matt Hunter
A 67 year old woman with a history of hypertension, hyperlipidemia, diabetes, and a 25 pack year smoking history is referred your clinic and is referred for evaluation of her peripheral arterial disease. She reports pain with walking that has limited her doing some daily activities. How can you optimally manage this patient? Does she need an operation? In this episode, we will cover the basics of peripheral arterial disease, discuss the specifics of optimal medical management and dive into the nuances of when (or if) you should offer these patients an operation. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the definition, prevalence, and risk factors for peripheral arterial disease - Understand the specifics of optimal medical management of patients with peripheral arterial disease - Discuss the controversy regarding operative management of patients with claudication and review indications for an operation in patients with peripheral arterial disease - Review the appropriate anti-platelet and anti-coagulation strategies after interventions in patients with peripheral arterial disease References 1. Woo K, Siracuse JJ, Klingbeil K, Kraiss LW, Osborne NH, Singh N, Tan TW, Arya S, Banerjee S, Bonaca MP, Brothers T, Conte MS, Dawson DL, Erben Y, Lerner BM, Lin JC, Mills JL Sr, Mittleider D, Nair DG, O'Banion LA, Patterson RB, Scheidt MJ, Simons JP; Society for Vascular Surgery Appropriateness Committee. Society for Vascular Surgery appropriate use criteria for management of intermittent claudication. J Vasc Surg. 2022 Jul;76(1):3-22.e1. doi: 10.1016/j.jvs.2022.04.012. Epub 2022 Apr 22. PMID: 35470016. https://pubmed.ncbi.nlm.nih.gov/35470016/ 2. Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. Eur J Vasc Endovasc Surg. 2024 Jan;67(1):9-96. doi: 10.1016/j.ejvs.2023.08.067. Epub 2023 Nov 10. PMID: 37949800. https://pubmed.ncbi.nlm.nih.gov/37949800/ 3. Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, Chandra V, Drachman DE, Eaves JM, Ehrman JK, Evans JN, Getchius TSD, Gutiérrez JA, Hawkins BM, Hess CN, Ho KJ, Jones WS, Kim ESH, Kinlay S, Kirksey L, Kohlman-Trigoboff D, Long CA, Pollak AW, Sabri SS, Sadwin LB, Secemsky EA, Serhal M, Shishehbor MH, Treat-Jacobson D, Wilkins LR. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jun 11;149(24):e1313-e1410. doi: 10.1161/CIR.0000000000001251. Epub 2024 May 14. PMID: 38743805. https://pubmed.ncbi.nlm.nih.gov/38743805/ 4. Belch JJ, Dormandy J; CASPAR Writing Committee; Biasi GM, Cairols M, Diehm C, Eikelboom B, Golledge J, Jawien A, Lepäntalo M, Norgren L, Hiatt WR, Becquemin JP, Bergqvist D, Clement D, Baumgartner I, Minar E, Stonebridge P, Vermassen F, Matyas L, Leizorovicz A. Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. J Vasc Surg. 2010 Oct;52(4):825-33, 833.e1-2. doi: 10.1016/j.jvs.2010.04.027. Epub 2010 Aug 1. Erratum in: J Vasc Surg. 2011 Feb;53(2):564. Biasi, B M [corrected to Biasi, G M]. PMID: 20678878. https://pubmed.ncbi.nlm.nih.gov/20678878/ 5. Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, Diaz R, Alings M, Lonn EM, Anand SS, Widimsky P, Hori M, Avezum A, Piegas LS, Branch KRH, Probstfield J, Bhatt DL, Zhu J, Liang Y, Maggioni AP, Lopez-Jaramillo P, O'Donnell M, Kakkar AK, Fox KAA, Parkhomenko AN, Ertl G, Störk S, Keltai M, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Tonkin AM, Lewis BS, Felix C, Yusoff K, Steg PG, Metsarinne KP, Cook Bruns N, Misselwitz F, Chen E, Leong D, Yusuf S; COMPASS Investigators. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017 Oct 5;377(14):1319-1330. doi: 10.1056/NEJMoa1709118. Epub 2017 Aug 27. PMID: 28844192. https://pubmed.ncbi.nlm.nih.gov/28844192/ 6. Bonaca MP, Bauersachs RM, Anand SS, Debus ES, Nehler MR, Patel MR, Fanelli F, Capell WH, Diao L, Jaeger N, Hess CN, Pap AF, Kittelson JM, Gudz I, Mátyás L, Krievins DK, Diaz R, Brodmann M, Muehlhofer E, Haskell LP, Berkowitz SD, Hiatt WR. Rivaroxaban in Peripheral Artery Disease after Revascularization. N Engl J Med. 2020 May 21;382(21):1994-2004. doi: 10.1056/NEJMoa2000052. Epub 2020 Mar 28. PMID: 32222135. https://pubmed.ncbi.nlm.nih.gov/32222135/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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